Trapped Inside: An Underreported Nightmare

Dr. Lora Wiens
5 min readNov 6, 2020

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Andrea* went to the ER in an unresponsive state. She thought she was having a seizure. While she could hear, she could not see, speak, or move voluntarily. When she arrived at the ER, before she was assigned a room, she heard two men discussing whether she was faking her symptoms or if she was a drug addict. One of them advocated that the other move her limbs until she responded. When they moved her shoulder, she started crying because of pain due to a previously existing shoulder injury. However, she still could not talk or pull her arm away. The men interpreted her tears as evidence that she was indeed faking and they continued to move her arm.

Tonic Immobility, once called “rape paralysis,” is a part of the Cascade of Defenses shared by humans as well as all mammals. Most people are familiar with the first 3 defenses: fight, flight, and freeze. All three of these defenses put a mammal in a state of hyperarousal in order to prepare them for escape.

Less commonly known defenses are Tonic and Collapsed Immobility. Instead of preparing a mammal for escape, these defenses prepare us for death through the activation of the parasympathetic nervous system. Animals experience Immobility when they cannot escape a predator. Humans experience these defenses in response to traumatic events that may or may not include the threat of death. We can also experience Tonic and Collapsed Immobility in response to reminders of past traumatic events.

The difference between Tonic and Collapsed Immobility is a person’s level of consciousness. People in a state of Tonic Immobility, such as Andrea and Chris, remain conscious. Collapsed Immobility is a more extreme state where a person collapses into unconsciousness or semi-consciousness due to bradycardia and a lack of brain oxygen. Children are especially vulnerable to states of Tonic and Collapsed Immobility, as are adults who were traumatized as children.

States of Tonic Immobility can last from minutes to hours to days. During a state of Tonic Immobility, a person is conscious and may be able to walk, sit upright, and/or stand. Their eyes are often closed. If their eyes are open, their stare appears vacant. They cannot speak or move their limbs outside of what keeps them from bodily collapse. An article from the Harvard Review of Psychiatry…

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Dr. Lora Wiens

I am a Clinical Psychologist who specializes in trauma and Dissociative disorders. In my free time, I enjoy spending time in nature with my spouse and dogs.